A Systems-Based Practice Curriculum in Orthopaedics
Bibliographic record
Abstract
BACKGROUND: Teaching and assessment of the systems-based practice competency have been a challenge for many educators in graduate medical education. Previous research done at our institution demonstrated a marked inconsistency across institutions in educational content, methods of delivery, and performance assessment. As a result, we developed a 2-week health systems curriculum for orthopaedic surgery residents. METHODS: A 2-week health systems rotation was developed during which postgraduate year (PGY)-1 residents were excused from their normal clinical duties. Residents followed patients as observers of the health-care system, challenged to view health care through the eyes of the patient and to identify what could be done individually and collectively to provide a better and safer experience. Additional learning experiences were designed on the basis of our literature review. At the end of the rotation, residents discussed and provided a written summary of their experiences and completed an anonymous evaluation. Using a Likert scale (1 to 10), residents were asked if the experience was educational and whether it was it additive to their undergraduate medical education for each of the 9 educational areas. RESULTS: The mean responses for all 9 educational areas were 8.2 for whether the experience was educational and 8.3 for whether it was it additive to participants' undergraduate medical education. Feedback from residents indicated that they found the course very helpful and that it inspired them to consider how they could "create overdue and necessary changes in our health-care system." CONCLUSIONS: Our health systems rotation in PGY-1 has been a valuable learning experience for the residents and has created a foundation on which to build in subsequent years of residency.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.004 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.008 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".